Mayberry, Tracy Smith
Mayberry, Tracy Smith is an sole proprietor health care provider with primary practice located at 1683 Washington Rd , East Point GA 30344-4265. She recently has 6 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Radiology, Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Foot Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Podiatrist is her primary health care specialty. Mayberry, Tracy Smith can be contacted via phone (404) 766-6400.Contact Information
Primary practice address
1683 Washington Rd
East Point GA 30344-4265
Phone: (404) 766-6400
Fax: (404) 766-6450
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine | 213EP1101X | POD000763 | Georgia |
| Podiatric Medicine & Surgery Service Providers / Radiology | 213ER0200X | POD000763 | Georgia |
| Podiatric Medicine & Surgery Service Providers / Sports Medicine | 213ES0000X | POD000763 | Georgia |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | POD000763 | Georgia |
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | POD000763 | Georgia |
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 000763 | Georgia |
Profile Details
| NPI number | 1497738413 |
|---|---|
| LBN Legal business name | Mayberry, Tracy Smith |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 23rd, 2005 |
| Last updated | Feb 8th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497738413 | NPPES |
| Georgia | Other | 480028687 | RAILROAD MEDICARE |
| Georgia | MEDICAID | 000672119F | RAILROAD MEDICARE |
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